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NPI Code Detail

MEDICARE: FERNANDO BONAFOUX

MEDICARE: FERNANDO BONAFOUX
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12355S0801XSpeech-Language Assistant1708-2PR

General Provider Information

NPI Number : 1811224678
Entity Type Code : Individual
Provider Name (Legal Business Name) : FERNANDO BONAFOUX
Provider Business Mailing Address
First Line : 1508 CALLE MARIBEL
Second Line :
City : SAN JUAN
State : PR
Zip : 00911-1683
Country : US
Telephone Number : 787-345-1125
Fax Number :
Provider Business Practice Location Address
First Line : 759 AVE AVELINO VICENTE
Second Line :
City : SAN JUAN
State : PR
Zip : 00909-2538
Country : US
Telephone Number : 787-724-5559
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2009
Last Update Date : 11/14/2009

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Directions to “ FERNANDO BONAFOUX ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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